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General NPI Number Information
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NPI Number | 1669091815
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Entity Type | Individual
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Provider Name | JENNA DENE MILAZZO PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 2805 NE 129TH ST
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City | VANCOUVER
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State | WA
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Zip | 98686-3324
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Country | US
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Telephone | 360-356-7247
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Fax |
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Provider Business Mailing Address
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Address Line | 3512 E MCLOUGHLIN BLVD
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City | VANCOUVER
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State | WA
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Zip | 98661-5470
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Country | US
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Telephone | 360-224-8718
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH60600355
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License Number State | WA
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